Provider Demographics
NPI:1598232860
Name:STONICHER, KATIE MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:MARIE
Last Name:STONICHER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MARIE
Other - Last Name:STUTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 BOWEN LN
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-5358
Mailing Address - Country:US
Mailing Address - Phone:337-280-1359
Mailing Address - Fax:
Practice Address - Street 1:1214 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2621
Practice Address - Country:US
Practice Address - Phone:337-289-7991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP10080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily